Out of the loupe: The prevalence of coaxial misalignment of surgical loupes among dental professionals.

BACKGROUND: Surgical loupes have been increasingly popular among dental professionals for their visual and postural benefits. However, dental professionals will receive the full benefit of surgical loupes only if the loupes are adjusted fully to fit the individual needs of each clinician. In this study, the authors examine coaxial alignment of surgical loupes, a critical criterion for the proper adjustment of these optical systems. METHODS: The authors conducted an in-person survey by using a simple, quantitative visual tool to assess the coaxial alignment of surgical loupes among 97 dental professionals in British Columbia, Canada. RESULTS: Findings indicated that 82% of dental professionals surveyed experienced coaxial misalignment with their surgical loupes. Dental professionals wearing front-lens-mounted (flip-up) surgical loupes with full vertical adjustability, front-lens-mounted surgical loupes with limited vertical adjustability, and through-the-lens surgical loupes were equally likely to be practicing with coaxial misalignment of their surgical loupes. Front-lens-mounted surgical loupes with full vertical adjustability were the only type of surgical loupe that can be adjusted to achieve full coaxial alignment reliably (P < .05). CONCLUSIONS: There was a high prevalence of coaxial misalignment among dental professionals in this cohort. Not all surgical loupes on the market satisfy the criteria for optimal postural and visual support of clinicians. PRACTICAL IMPLICATIONS: The visual tool developed in this study enabled dental professionals to identify coaxial misalignment effectively and efficiently. Findings from this study will assist dental professionals in making informed decisions when choosing their magnification equipment and prompt surgical loupe manufacturers to develop more evidence-based products.

Introducing Clinical Hypnosis to Dentists: Special Challenges and Strategies.

Dentistry is a natural match for clinical hypnosis. The special characteristics and requirements of dental diagnostic and treatment processes offer daily opportunities for dentists and patients to replace anxiety, pain, and uncontrolled challenges with confidence, comfort, and fully controlled solutions. The ways in which hypnosis can be used in dentistry are reviewed. However, dentists have not as a profession readily accepted, studied, nor utilized hypnosis for their clinical practices. The reasons for this poor linkage are catalogued and explained to both dentist and nondentist readers. Strategies and suggestions are made for introducing clinical hypnosis to dentists so that they might more readily and fully integrate useful hypnotic techniques into their dental practices.

Development and retention of fine psychomotor skills: implications for the aging dentist.

Dentistry is a profession that involves the acquisition and maintenance of fine psychomotor skills. The many components of the motor system in the brain work together during all movements, but each area is activated to a varying degree depending on whether an individual is learning, training or maintaining expertise. The transition from nonexpert to expert involves practice and experience to allow imprinting of neuronal connections within the brain, which in turn causes those practised movements to become automated. With age, many people slowly lose memory, but are the fine motor movements that a dentist has mastered over a lifetime also lost? The aging expert experiences the same deterioration as an aging nonexpert in tasks that are unrelated to the expertise, but tasks that an expert has selectively maintained through decades of practice are retained through aging.

Dentistry--a show of hands, please!

Dentists have historically derived a distinctive part of their identity from the role of hand skills in practice. Dentistry is a surgical discipline, requiring a basic competency to perform what has been diagnosed and planned as being in the patients' best interests. Dental education has introduced magnification and computer-assisted technique instruction as the proportion of clock-hours devoted to laboratory practice has decreased. The threats posed by traumatic hand injury to practitioners are unknown, but may be small. By contrast, the strain of repetitive motion and injuries caused by postural problems are reported to be widespread in the profession and is generally accepted as characteristic and unavoidable. Ergonomic approaches to alleviating work strain have not been broadly embraced. As dentistry incorporates more biological alternatives and automated technology, the role of hands in practice may change.

Ergonomic risk factors associated with clinical dentistry.

Ergonomics has formed an integral aspect of dental education at the University of British Columbia since the early 1980s. However, studies continued to indicate that dentists are at risk for developing musculoskeletal problems. This provided the impetus for a study of the risk factors associated with these problems. The data analyzed from 421 survey respondents in British Columbia indicate that indeed dentists are experiencing musculoskeletal pain and discomfort. However, the data also suggest that dentists can recognize and identify their own postures, practicing positions, and the equipment usage patterns that are associated with increased risks of experiencing musculoskeletal pain and discomfort. Such recognition is the first critical step to avoiding or neutralizing ergonomic habits and work environment layouts that might otherwise unnecessarily shorten professional clinical careers.